New Public Speakers Application Form

Discovery Questions and Insight

We want to learn more about you!

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1.What is your first name?

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2.What is your email address?

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3.Are you currently a Public Speaker or do you want to be? Please share the short version of your story...

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4.How often have you spoken on stage? Please elaborate...

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5.What topics do you prefer to speak about?

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6.What price range would you say your speaking engagements are at currently?

$1,000 and less

$1,000 - $5,000

$5,000 - $10,000

$10,000 - $15,000

$15,000 - $25,000

$25,000 and up

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7.Have you ever hired a Publicist or Speaking Agent before?

YES

NO

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8.How did you hear about Karie Millspaugh with Abundant Living by KLM?

Social Media

Networking event

Television

Email Database

Referral

Media/Interview/Advertisement

Podcast Interview

Blog

Other

Thank you for taking the time to submit these answers, someone from my team will be contacting you shortly with a link to my calendar if you've not scheduled a time yet. If you do not get a response within 24 hours, please contact me direct at karie@kariemillspaugh.com

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9.If referred to our services, please include their first and last name and/or company name